Mayo Clinic Dramatically Cuts Down On Radiation Exposure From X-rays

Since their first medical use in to late 19th century, X-rays have been a useful and fascinating tool. When inventor Wilhelm Rontgen produced the first-ever X-ray image of his wife´s arm, she proclaimed, “I have seen my death.”

Rontgen´s wife may have unwittingly made a dire warning as the benefits of the technology are somewhat offset by the damage carcinogenic X-rays cause to the skin and human DNA.

However, the Mayo Clinic has instituted a new set of policies that reduces patient exposure to the harmful radiation associated with X-ray imaging by almost 50 percent, while maintaining an elite level of care.

To cut the amount of radiation that patients and staff are exposed to during cardiovascular procedures, the clinic made targeted alterations to the use of their X-ray equipment and revamped the radiation safety training program, according to a report on the changes published in the latest edition of the Journal of the American College of Cardiology: Cardiovascular Interventions.

“Through our efforts, we were able to quickly cut the overall radiation exposure to patients by nearly half using simple but effective methods,” said Dr. Charanjit Rihal, chair of Mayo’s Division of Cardiovascular Diseases. “We think this program could serve as a useful model for other cath labs in the U.S.”

According to the clinic´s Dr. Kenneth Fetterly, physicians should shift their priorities when it comes to X-ray imaging. He said the industry should focus less on attaining the highest image quality and more on lowering the amount of radiation exposure.

With this new attitude in mind, Mayo instituted a wide-ranging program that increased awareness about radiation safety. The clinic also changed the way technicians and doctors use standard X-ray systems. For example, medical staff use a very low setting as the default position to minimize the radiation dose to their patients. The machine operators are now instructed to increase the radiation dose only if higher-quality images are needed during a critical portion of a procedure. The new policy results in useful images while lowering radiation exposure.

Over the three-year course of the study and analysis of the new program, 18,000 procedures at Mayo were performed by 27 staff cardiologists and 65 fellows-in-training. The analysis team calculated and then compared the cumulative skin dosage of radiation for procedures performed during the first and last quarters of the study period.

Researchers noticed a 40 percent drop in average radiation exposure over three years. The decrease for percutaneous coronary intervention, coronary angiography, non-cardiac vascular interventions and interventions to treat structural heart disease ranged from 34 to 53 percent.

Fetterly stressed that practices should implement changes to their X-ray imaging policy on a broad-based scale and across many different procedures as the Mayo Clinic has to see the most effective reductions in radiation exposure.

“We need radiation to be able to see what we are doing in a patient, so X-ray imaging has a definite benefit, but excessive doses of radiation can cause problems,” Dr. Rihal added. “These are good procedures. We just made them safer.”